Deborah Howell (Host): Nurses serve a vital role for fertility patients, acting as your guiding light during treatment. They're educators, confidants, and unwavering pillars of support, dedicated to demystifying the treatment process and standing with you every step of the way. Amber Kiddie, a Registered Nurse and Nurse Educator at Fertility Centers of Illinois, joins the Time to Talk Fertility podcast to explain the invaluable contributions of fertility nurses in your quest for parenthood.

Welcome, Amber!

Amber Kiddie, RN: Thank you for having me, Deborah. I really appreciate this opportunity to chat.

Host: A pure delight to have you. Now you've been in this field for quite some time. What inspired you to specialize in fertility nursing?

Amber Kiddie, RN: I've been a fertility nurse now for 10 years and I came from hospice. And what I really liked about fertility is that you, had all of the same emotions, but you had a better ending and, it really required you to use your brain and partner with the physician as well as helped create families and see miracles every day.

So, that's what I'm here for.

Host: Can't get better than that. And what does your role as a fertility nurse entail?

Amber Kiddie, RN: You know, we help manage the caseload of the physician. So the physician gives us the treatment plan and then we guide the patient through the grueling process of fertility. We try to make it as easy and smooth going as possible.

Host: What kind of training or certification is required to become a fertility nurse?

Amber Kiddie, RN: So you have to have a nurse license as well as CPR certification. We do like experience, but we're certainly willing to train. But really women's health passion really helps you to make sure that you're ready for this in addition to making sure that you're comfortable with maintaining that patient care because some of these patients may be with you for a little bit longer.

Host: Yeah, for sure. Now, I'm hoping you could walk us through a typical day in the life of a fertility nurse.

Amber Kiddie, RN: Absolutely. I'd be so happy to do that. You know, each day looks a little bit different depending on if the physician is in the office seeing patients, bcause you will see those patients after the physician sees them. So the physician reviews everything, gives them the plan, and then they meet up with the nurse to review what the next steps are.

 How do we break down this plan and make sure that we get all of our T's crossed, our I's dotted, and get everything ready for the physician to give us a further treatment plan. So when the physician's in the office, it's busy. We're running around after they do a procedure. We're making sure you understand.

We're making sure that patients are getting calls to review their next steps. When a physician's not in the office, we're scheduling nurse consults, where we do some training and education on what the patient's treatment plan looks like, as well as ordering medications, coordinating with the pharmacy, coordinating with the phlebotomist, andrologist, the front desk, getting patients scheduled.

Patients come in in the morning and they get the results in the afternoon and so they have to hear from us every day. So that acuity keeps us on our feet and busy. In addition, we do procedures. So we get to do the IUIs where we put the sperm into the uterus and help with the pregnancy. So that's always exciting too, to add a little clinical hands on to our day.

Host: Amazing. And how do fertility nurses support patients at the very beginning of their fertility journey?

Amber Kiddie, RN: We can support patients by being receptive, understanding where they're coming from, and meeting them where they're at. Patients come to us after a long time of trying, or this is fresh and new to them. Some patients have been very researched, and some just don't know what to expect.

And so, meeting the patient where they're at, and then addressing their questions and concerns as they go is really what makes the difference.

Host: That's perfectly reasonable. And what types of procedures or treatments do you most commonly assist with? You got into a couple before.

Amber Kiddie, RN: Oh, yes. So, we do the most basic which is, you know, ovulation tracking and medication support within a cycle, all the way up to stimulating the ovaries for timed intercourse or an intrauterine insemination or an IUI. And then the most aggressive is IVF where we stimulate the ovaries and do a retrieval, take the eggs out to meet them with a nice sperm and make those embryos.

And then they can decide if they want to do genetic testing on the embryos or do a fresh transfer. If they decide to do genetic testing, then we're talking about doing a frozen embryo transfer. So we've already got the embryo now, we have to put it back in. We run the gamut. There's very minimal support all the way to pretty intense.

We're kind of figuring out everything. We also do egg freezing and fertility freezing as well as third party cases using a gestational carrier, using a donor sperm source, using a donor eggs, donor embryos, et cetera. So we kind of see it all.

Host: Right. And this is for women who aren't quite ready to get pregnant now, but want to make sure they have that option in the future, right?

 Mm hmm

Amber Kiddie, RN: For fertility preservation. Absolutely. Yes.

Host: How do you help patients understand their fertility treatment protocols?

Amber Kiddie, RN: That's a unique scenario per physician protocol. So the nurse's job is to interpret what the physician wrote down and translate that to the way that the patient understands the best. And so that looks different depending on, again, your education level, what your questions are, and your concerns.

But, we have lots of different resources. We have online education, as well as translators, and, make sure that we communicate with the patient frequently so that they can understand how we're going to go about that process.

Host: And again, you covered some of this, but how do you ensure that information is clearly conveyed to patients?

Amber Kiddie, RN: You know, we have a few different routes of communicating with patients. I like to call patients and then follow up with a portal message. Our portal is a secure, HIPAA secure, way to reach out to patients. Very similar to email. They get an email notification and then they sign up through their portal.

It's a nice visual, but we really like to make sure that patients are getting their phone calls and understanding. The last thing that we like to do is if the patient is in office and we have the opportunity to meet with them, we love to sit down and chat with any questions or concerns because it's the easiest to assess when you're chatting.

Host: Yeah, for sure. All right, now down to the nitty gritty. Administering medication can be really daunting for some patients. How do you teach and support them through that?

Amber Kiddie, RN: It is really daunting. You're absolutely right, especially with those that are needle averse. I myself went through fertility and so I've been on the business end of that needle. I think, being afraid of needles is very reasonable. And so we have quite a few resources, including online videos, we do in person medication teaches for the nurse to show on a, like a skin blob that we have, it's a fake skin blob, how the injection goes.

We also have other resources like a fertility concierge, that's not with our company, but they're are specific licensed nurses that can come out to your house for a fee and give you those injections. So there's quite a few resources out there these days.

Host: Yes. And what would you say is the biggest challenge you face when helping patients with their fertility treatments?

Amber Kiddie, RN: I think fertility is a very emotional journey, and it's something that you've wanted, you've experienced loss, or you feel like there's something missing, and so I think managing the stress and emotion, along with the difficulty of working with your insurance and working with your pharmacy when you've never had to deal in the medical field before.

So we have a lot of times very healthy patients that have never had to go to the doctor frequently, never had to have these interactions, and now all of a sudden you're knee deep in everyday monitoring labs and ultrasounds, you know. So it's a matter of being very clear of your communication and making sure that the patient understands what they're going through. It's definitely a give and take and the patient's participation really makes a difference.

Host: And hearing you say that makes me want to ask you about emotional support. That's got to be a significant aspect of fertility care. How do you provide that to your patients?

Amber Kiddie, RN: It's a great question. We do have a psych team as well as a social worker that provides some counseling services. We have groups that meet to give that community. I know there are online groups as well, but here at FCI, we're hoping that our nurse, physician, phlebotomist, everyone from the ground up is able to provide that care and make sure that you're feeling welcome and taken care of during this journey.

Host: I can hear the warmth in your voice, and I can just feel the support. Maybe you could share a particularly rewarding experience you've had with a patient or a couple.

Amber Kiddie, RN: I've been here 10 years and I've had so many, which is really nice. Such a gift. I think what is really cool is watching a couple come back, most recently for me since I've been here 10 years, coming back for their second child because you know how hard it was for them the first time, you got to see that success, and now they're back to build that family and it's really exciting, The other really big one that I can remember or think of off the top of my head is we had a couple that was doing IVF and didn't have a good sperm count and they ended up having to convert their IVF cycle because she just was not responding very well.

They converted to an IUI where we put the sperm into the uterus and the success rates on that are much lower and so we were nervous and our sperm sample was not as high as we wanted and I met that baby a year later and it was really amazing. Well, obviously 10 months later, but it was really wonderful.

We love seeing the babies come back or send pictures with the updates. And what's really wild to me is I see these people out in the community in their family, enjoying what they're doing. And so it's, it's really rewarding getting to see that.

Host: So lovely. And how do you stay updated with the latest developments in fertility treatment?

Amber Kiddie, RN: We have continuing education. We also have a residential program where they bring to us most up to date what's going on. We go to different conferences and make sure that we're staying as up to date. FCI has a really great program where we're allowed to collaborate with many other practices and make sure that we have the newest technology, the best equipment, and the most educated nurses that we possibly can.

Host: You'd make me want to sign up to be a fertility nurse at FCI

Amber Kiddie, RN: Yes,

Host: just talking to

Amber Kiddie, RN: come on over. You let me know. We've got some good training.

Host: I'm sure you do. Now, how do fertility nurses collaborate with the rest of the fertility care team?

Amber Kiddie, RN: There's multiple ways that we collaborate. One is in office. We're a very close, tight knit, community within the office, and we also use our email, our electronic medical record system, to put in the notes and document very clearly, and a lot of times, it's picking up a phone and chatting with someone. I just spoke with our financial coordinator today to help get a patient set up for her treatment cycle.

She's getting ready to start today and they had some questions about the treatment that we were doing and when they understand the process, they're able to provide that care from even a billing perspective, even better and so it's really a great opportunity to collaborate.

Host: Sounds like it. Final question for you. What advice do you have for anyone going through infertility treatment?

Amber Kiddie, RN: Well, I have so much advice, but mostly is hang in there. It is hard. It is a journey, but the reward is so worth it.

Host: Absolutely. And do you have any last thing you'd like to add to our conversation?

Amber Kiddie, RN: I appreciate you taking the time to discuss this. I know that fertility is still kind of a hush, hush, conversation. And so it's so nice to get it out there and for other people to hear what services are available, how to interact with their medical staff. And, if we don't know that there's a problem, you've got to reach out, but we're going to be reaching out to you and making sure that you understand how to move forward and that you understand what you're going through.

So I think that's just so important and hopefully opens the door for a lot of people to continue to reach out.

Host: Agree. 100%. . Well, Amber, we can't thank you enough for being with us today and helping us understand so much more about the role of a fertility nurse. Thank you again for your time today.

Amber Kiddie, RN: Thank you, Deborah I appreciate it.

Host: That's Amber Kiddie, Registered Nurse and Nurse Educator at Fertility Centers of Illinois. You can call 877-324-4483 to schedule an appointment or visit fcionline.com for more resources. And if you enjoyed this podcast, you can find more like it in our podcast library, and be sure to give us a like and a follow if you do.

This has been the Time to Talk Fertility Podcast. I'm your host, Deborah Howell. Have yourself a terrific day.